Individual
BREANA CANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1027 E BARBARA PL, 5, SALT LAKE CITY, UT 84102-3149
(972) 322-0017
Mailing address
1027 E BARBARA PL, 5, SALT LAKE CITY, UT 84102-3149
(972) 322-0017
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
9492593-4104
UT
Other
Enumeration date
11/17/2015
Last updated
11/17/2015
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